calcification AV, MV

82/F Patient history : dementia, cerebral infarction(10 years ago), hypertention Chest PA : cardiomegaly <img src="https://t1.daumcdn.net/cfile/cafe/19787B3A50B994481F" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_19787B3A50B994481F6E67"/> pic 1.  LVH with strain           cannot rule out lat-wall ischemia           ST segment elevation of ant wall   <img src="https://t1.daumcdn.net/cfile/cafe/0304B43A50B9944910" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_0304B43A50B994491092D4"/>  pic 2. AV calcification , LA 커져 있음.   <img src="https://t1.daumcdn.net/cfile/cafe/1909913A50B994490A" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1909913A50B994490A7915"/>  pic 3. EKG 상 LVH와 ischemic 예상 되었다.           LVH 는 있었고. 다행히 wall motion 은 괜찮아 보였음.     <img src="https://t1.daumcdn.net/cfile/cafe/1262063A50B9944A34" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1262063A50B9944A347655"/>  pic 4. SAX view 에서 wall thickness measure - septal 13mm, inferior - 13mm   <img src="https://t1.daumcdn.net/cfile/cafe/0201BE3A50B9944A13" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_0201BE3A50B9944A1334FA"/>  pic 5. SAX - AV valve (calcification NCC)   <img src="https://t1.daumcdn.net/cfile/cafe/1661103A50B9944A31" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1661103A50B9944A31EB3B"/>  pic 6. AV planimetry ( 1.59 Cm2)   <img src="https://t1.daumcdn.net/cfile/cafe/1902263A50B9944B13" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1902263A50B9944B13D51D"/>  pic 7. MV calcification (posterior leaflet)   <img src="https://t1.daumcdn.net/cfile/cafe/130B353A50B9944B08" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_130B353A50B9944B08774E"/>  pic 8. MR   <img src="https://t1.daumcdn.net/cfile/cafe/130DA53A50B9944B05" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_130DA53A50B9944B05C21F"/>  pic 9. LA volume - 57ml (enlarged)   <img src="https://t1.daumcdn.net/cfile/cafe/192A053450B9944B12" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_192A053450B9944B12C645"/>  pic 10. MV calcification ( 4CV, PLAX)             - 4 chambe view 에서 post. leaflet 이 안열리는 것 처럼 보였으나 zoom 해서 보니 열리긴 했습니다.   <img src="https://t1.daumcdn.net/cfile/cafe/151BA83450B9944C22" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_151BA83450B9944C2222C7"/> pic 11. LV wall motion (compare with systolic and diastolic)   AVI file - 4CV view 에서 mitral posterior leaflet 안열리는 것처럼 보이나 아래 다른 scan position 에서 보시면              열리는 것을 확인 할 수 있습니다.   <iframe id="_hFEFUjvaIM$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/_hFEFUjvaIM$@my?service=daum_cafe&ptoken=v2_b7bd7e5bb75f616fd7d85d88684087ea1027eeb45e216e37b9fc9713d0a15a723ca26bd27705a9707f2b923c81aef00b490e537727293b4c130bc35f" frameborder="0" scrolling="no" allowfullscreen></iframe>     <iframe id="mv62zzQw9Ic$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/mv62zzQw9Ic$@my?service=daum_cafe&ptoken=v2_0684a73d6f244e9e6448f9e68388b4be427200f1dcd05c7b5d211e9bd3c0bd7a1126d2b474a4145bf39104473bb2ad49d3e9b994bebb188abbbbb485" frameborder="0" scrolling="no" allowfullscreen></iframe>     <iframe id="SPww9YJtntA$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/SPww9YJtntA$@my?service=daum_cafe&ptoken=v2_1795f1c5617dfcdc317b70d76a49977c281ff874fa52ebdd59f45429683c70d3e4a503feabbe5c1ac27e8f5c83d7a543febdcb97ed70ebe2f3b106b7" frameborder="0" scrolling="no" allowfullscreen></iframe>   <iframe id="FFyBEi3oSg4$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/FFyBEi3oSg4$@my?service=daum_cafe&ptoken=v2_674d158b79794660af231d1a52a4745db7f7e21cb6c730bf206997ea17b308d653f4694d2cce5aa520d1be9b8200f49787252b5d06d5b1dc8f4437d9" frameborder="0" scrolling="no" allowfullscreen></iframe>   <iframe id="hUL6uHXO5fQ$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/hUL6uHXO5fQ$@my?service=daum_cafe&ptoken=v2_8476de882d819ac7f146479a5933db435bc445c6f4bd21fd9611cc5c3f69e1c4f1db27a589b606ffb5af14dc286e6a06b4360e5a65e1011c81386fd4" frameborder="0" scrolling="no" allowfullscreen></iframe>